Health-E-Access The Health-E-Access Program, a telehealth network, is designed to increase access to healthcare for children, improve the economic stability of inner city families, and improve early education for underserved children. How It Works Health-E-Access connects an ill child and a Telehealth assistant located at a childcare center, with a physician or nurse practitioner, located at Golisano Children's Hospital, through a broadband digital communication link. Teleconferencing cameras allow real-time, face-to-face interaction. Basic examination tools such as endoscopes for ear, nose and throat exams, a stethoscope for heart and lung exams, and an all-purpose camera that allows high quality still images for skin and eye problems, are located at the child care centers. Why It Is Needed Child illness is a very common and challenging problem both for families who rely on childcare centers and for the staff responsible for the health and safety of all enrolled children. Unfortunately, the children most burdened by illness, and whose reliance on childcare is most important to their ability to improve their economic circumstances, are those least equipped to deal with the challenge. Without adequate access to healthcare, inner city children receive delayed and less effective treatment and face more illness than children in more affluent areas. Transportation is large barrier to receiving care. Based on the 1990 U.S. Census, 42% of Rochester's inner city households had no automobile. A child's illness accounts for a large proportion of missed work for childcare parents. Many inner city parents, who jeopardize employment if they leave work as demanded, don't have access easy access to a medical professional to gain care and return the child to childcare. Because of these many obstacles to care, a child may wait for hours or even a day or longer before receiving adequate care. In the meantime, the child often suffers unnecessary pain, risks a worsened condition, and is more likely to experience chronic illness. Measuring the Success of Health-E-Access Health-E-Access has been operating for 18 months in three inner-city childcare centers and currently has 578 children active in the program. Parents of children who have used telehealth report that the telehealth visit allowed them to avoid health services utilization, allowed them to stay at work, and said that they would choose a child care center with telehealth over one that does not have telehealth. Parents estimated that each telehealth encounter allowed them to save almost 5 hours of work time. For hourly-wage workers, this is important. An added benefit is the improved quality of diagnosis. For example, in a typical office visit the doctor may struggle to get a good view of a fidgeting child's ear drum for a few seconds at best, upon which she will make her diagnosis. Compare this to having a video of the same ear, with multiple views from which to capture the best still image and have the opportunity to review for as long as needed to make a diagnosis.